刘志辉+邹翰琴+刘慧

[摘要] 目的 探讨宜宾地区孕11～13+6周胎儿心脏轴角度的参考值范围。 方法 选取2014年6月～ 2016年3月来我院做颈项透明层检测的11～13+6周单胎孕妇，在四腔心切面上进行胎儿心脏轴角度测量，计算各孕周正常胎儿心脏轴角度参考值范围。 结果 986例胎儿1576次测量纳入统计。各孕周胎儿心脏轴角度随孕周增长而增大。孕11～11+6周的均数为（43.06±3.82）°，第50百分位数为43.40°；孕12～12+6周的均数为（45.82±2.87）°，第50百分位数为45.50°；孕13 ～ 13+6周的均数为（46.99±2.67）°，第50百分位数为47.00°；不同孕周胎儿心脏轴角度的差異有统计学意义。 结论 宜宾地区孕11 ～ 13+6周胎儿心脏轴角度参考值范围，其结果对筛查早孕期胎儿先天性心脏病有所帮助。

[关键词] 早孕期；胎儿；心脏轴；先天性心脏病；参考值范围

[中图分类号] R714.5 [文献标识码] A [文章编号] 2095-0616（2017）06-16-04

[Abstract] Objective To discussion of reference values of the angle of fetal cardiac axis at 11-13+6 Gestation Weeks in Yinbin area. Methods The cardiac axis， angles were measured at four chamber view in singleton fetuses at 11-13+6 gestation weeks from Jun. 2014 to Mar.2016. The reference values were calculated by statistical methods. Results A totle of 1576 measurements from 986 fetuses， were included in this study for analysis. The fetal cardiac axis， angles increased with gestational week. The mean value was （43.06±3.82）°， and the 50th percentile were 43.40° at 11-11+6 week. The mean value was （45.82±2.87）° at 12-12+6 week， and the 50th percentile were 45.50°. The mean value and 50th percentile were （46.99±2.67）° and 47.00° at 13-13+6 week. The differences among three different weeks were statistically significant. Conclusion The reference values of cardiac axis angle at 11-13+6 gestation weeks fetuses in Yibin area is established. It may be valuable on the screening of congenital heart disease in fetuses at 11-13+6 gestation weeks.

[Key words] First trimester； Fetal； Cardiac axis； Congenital heart disease； Reference value range

运用心脏轴角度筛查中晚孕期胎儿先天性心脏病早已得到共识。胎儿心脏轴在中晚孕期的参考值范围为中轴偏左（45±20）°[1]。但目前对早孕期胎儿心脏轴研究却不多，其研究结果也各有不同，国内外尚无统一的参考值标准。本研究通过大样本测量并统计宜宾地区孕11～13+6周正常胎儿心脏轴，旨在探讨该区域该孕龄胎儿心脏轴角度的参考值范围，以期对早孕期胎儿先天性心脏病的筛查有帮助。

1 资料与方法

1.1 一般资料

选取2014年6月～2016年3月来我院做颈项透明层检测的11～13+6周孕妇。纳入标准：顶臀长在45～84mm（相当于孕11～13+6周）的单胎。排除标准：失访或中孕前终止妊娠或流产的胎儿，中晚孕或出生后诊断有先天性心脏病的胎儿。……